Background/purpose: Optical coherence tomography angiography has been used to evaluate the posterior segment in a wide variety of pathologies because it is a noninvasive image technique, but its role in the evaluation of the retina in a case of carotid cavernous sinus fistula has not been described yet.
Methods Results: We present a patient who consulted with spontaneous left superior eyelid hematoma and was diagnosed with left indirect carotid cavernous sinus fistula. In this study, optical coherence tomography angiography was used to evaluate the different macular capillary plexuses in a patient with carotid cavernous sinus fistula and a clinical situation of secondary local venous stasis before and after percutaneous embolization. Augmented vessel density was seen in superficial and deep capillary plexuses and in choriocapillaris before the percutaneous embolization, and a decrease of the parameters was seen after the treatment.
Conclusion: All macular capillary plexuses presented with augmented vessel density levels that normalized after treatment. These findings were previously undescribed, and they suggest that optical coherence tomography angiography may be useful to initially evaluate patients with carotid cavernous sinus fistula who are planned to undergo embolization and to follow them up until normalization of the vascular structures is reported.
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http://dx.doi.org/10.1097/ICB.0000000000001224 | DOI Listing |
J Neurosurg Pediatr
January 2025
1Neurotology Unit, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow; and.
Objective: The objective of this study was to discuss the characteristics of intracranial extension in patients with juvenile nasopharyngeal angiofibroma (JNA) and propose and an algorithm for its management.
Methods: A retrospective chart review of all patients with JNA who underwent operations between January 2013 and January 2023 was done, and those cases with intracranial extension categorized as stage IIIb, IVa, and IVb according to the Andrews modification of the Fisch staging classification were included in the study. Data were collected about age at presentation, symptoms, radiological findings, routes of intracranial extension, therapeutic management, and follow-up.
World Neurosurg
December 2024
Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan.
Background: Flow diverters (FDs) have been introduced for the management of large or giant cavernous carotid aneurysms (CCAs) in addition to conventional modalities, dramatically changing treatment strategies. The aim of this study was to examine the management of unruptured large/giant CCAs in Japan when FDs were being introduced using a nationwide survey.
Methods: 540 unruptured large/giant CCAs treated at neurosurgical teaching departments in Japan between 2012 and 2016 were retrospectively studied.
Surg Radiol Anat
December 2024
Department of Neurosurgery, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa, Sayama, Saitama, 350-1305, Japan.
Purpose: To describe a case in which a right replaced posterior cerebral artery (PCA) was associated with an ipsilateral superior cerebellar artery (SCA) type persistent trigeminal artery (PTA) variant.
Methods: A 53-year-old man who had been diagnosed with chronic dissection of the left vertebral artery (VA) 4 months previously underwent follow-up magnetic resonance (MR) angiography using a 3-Tesla scanner.
Results: MR angiography showed a slightly dilated left VA at the terminal segment without interval change.
Surg Radiol Anat
December 2024
Department of Neurosurgery, Nagoya University of Graduate School of Medicine, Tsurumai-Cho 65, Showa-Ku, Nagoya, Aichi, Japan.
Purpose: We report a case of regression of a 2-year-old girl with bilateral primitive ophthalmic arteries (POAs).
Case Report: The patient presented with a headache and had no visual impairment or visual field abnormalities. Magnetic resonance angiography (MRA) revealed arteries originating bilaterally from the cavernous internal carotid artery segments, diagnosed as persistent POAs.
Cureus
November 2024
Neurosurgery, University of Illinois College of Medicine Peoria, Peoria, USA.
Petroclival approaches remain challenging given abundant cranial nerves and vessels. Common trajectories include transsphenoidal, transoral, middle fossa-extradural, and posterior through the cerebellar peduncle. We report a unique intra-axial, intradural approach to the petroclival and cavernous sinus.
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